Transfusion support for a patient with alloanti-D and the RHD*DV.1 allele.

Autor: Jiang L; Laboratory Medicine Center, Department of Transfusion Medicine, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China., Du Y; Laboratory Medicine Center, Department of Transfusion Medicine, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China., Hao K; Laboratory Medicine Center, Department of Transfusion Medicine, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China., Mei M; Laboratory Medicine Center, Department of Transfusion Medicine, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China., Li Y; Laboratory Medicine Center, Department of Transfusion Medicine, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China., Chen B; Laboratory Medicine Center, Department of Transfusion Medicine, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China. Electronic address: 1844035880@qq.com., Xie Y; Laboratory Medicine Center, Department of Transfusion Medicine, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China. Electronic address: xieyiwei@hmc.edu.cn.
Jazyk: angličtina
Zdroj: Clinica chimica acta; international journal of clinical chemistry [Clin Chim Acta] 2023 Feb 15; Vol. 541, pp. 117268. Date of Electronic Publication: 2023 Feb 24.
DOI: 10.1016/j.cca.2023.117268
Abstrakt: Background: Safe blood transfusion is significantly affected by the complex antigen polymorphism and a high proportion of autoantibodies of the Rh blood group system.
The Patient and Methods: A male Chinese patient with primary biliary cirrhosis, esophageal and gastric rupture, and bleeding was admitted to our hospital. Blood typing identified that he had serological O and D+ blood groups. Because autoantibody was not detected using routine immediate spin (IS) and indirect antiglobulin test (IAT), he was treated by transfusing D+ red blood cells (RBCs). However, this treatment was ineffective. Thus, manual polybrene test (MPT) and low ionic salt solution indirect antiglobulin test (LISS-IAT) were performed, followed by exon sequencing of the RHD gene.
Results: The patient was confirmed as a DV Type 1 individual by gene sequencing, and had 4+ RhD antigen agglutination. The anti-D in serum and elution could only be detected by MPT (2+ agglutination) and LISS-IAT methods (1+/3+ agglutination). It was presumed that attenuated alloantibody contributed to ineffective RBC transfusion, causing a transient increase in hemoglobin (HGB) before falling back to 50 g/L or even lower within four days.
Conclusion: Genotyping helps to support the specificity of detecting autoantibodies and alloantibodies. Combining more serological methods with molecular technology in blood typing is beneficial to improve the safety and effectiveness of blood transfusion.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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